﻿<?xml version="1.0" encoding="utf-8"?>
<!--100 Insurance Plan Description-->
<TransactionSpecification TransactionSetIdentifierCode="100" xmlns="http://tempuri.org/X12ParserSpecification.xsd">
  <Segment SegmentId="BGN" />
  <Segment SegmentId="C3" />
  <Segment SegmentId="DTP" />
  <Loop LoopId="NM1">
    <Name>Individual or Organizational Name</Name>
    <StartingSegment SegmentId="NM1" />
    <Segment SegmentId="N3" />
    <Segment SegmentId="N4" />
    <Segment SegmentId="REF" />
    <Segment SegmentId="PER" />
  </Loop>
  <Loop LoopId="N1">
    <Name>Name</Name>
    <StartingSegment SegmentId="N1" />
    <Segment SegmentId="N2" />
    <Segment SegmentId="N3" />
    <Segment SegmentId="N4" />
    <Segment SegmentId="COM" />
    <Segment SegmentId="III" />
    <Segment SegmentId="MSG" />
    <Loop LoopId="PER">
      <Name>Administrative Communications Contact</Name>
      <StartingSegment SegmentId="PER" />
      <Segment SegmentId="N3" />
      <Segment SegmentId="N4" />
    </Loop>
    <Loop LoopId="PID">
      <Name>Product/Item Description</Name>
      <StartingSegment SegmentId="PID" />
      <Segment SegmentId="LIN" />
      <Segment SegmentId="DTP" />
      <Segment SegmentId="NM1" />
      <Loop LoopId="BLI">
        <Name>Baseline Item Data</Name>
        <StartingSegment SegmentId="BLI" />
        <Segment SegmentId="DTP" />
        <Segment SegmentId="III" />
        <Segment SegmentId="AMT" />
        <Segment SegmentId="QTY" />
        <Loop LoopId="SI">
          <Name>Service Characteristic Identification</Name>
          <StartingSegment SegmentId="SI" />
          <Segment SegmentId="AMT" />
          <Segment SegmentId="QTY" />
        </Loop>
      </Loop>
      <Loop LoopId="AM1">
        <Name>Informational Values</Name>
        <StartingSegment SegmentId="AM1" />
        <Segment SegmentId="MSG" />
      </Loop>
      <Loop LoopId="PO1">
        <Name>Baseline Item Data</Name>
        <StartingSegment SegmentId="PO1" />
        <Segment SegmentId="LIN" />
        <Segment SegmentId="SPA" />
        <Segment SegmentId="III" />
      </Loop>
      <Loop LoopId="N4">
        <Name>Geographic Location</Name>
        <StartingSegment SegmentId="N4" />
        <Segment SegmentId="SPA" />
        <Loop LoopId="AM1">
          <Name>Informational Values</Name>
          <StartingSegment SegmentId="AM1" />
          <Segment SegmentId="MSG" />
        </Loop>
        <Loop LoopId="PO1">
          <Name>Baseline Item Data</Name>
          <StartingSegment SegmentId="PO1" />
          <Segment SegmentId="SPA" />
          <Segment SegmentId="III" />
        </Loop>
      </Loop>
    </Loop>
  </Loop>
</TransactionSpecification>